【論文摘要】Consideration of Intervention in Fracture Post-Acute Care: A Case Report With Femoral Neck Fracture

【論文摘要】脆弱性骨折之急性後期照護介入考量：股骨頸骨折個案報告

伊薇靜(Wei-Jing I) ； 蕭愛香(Ai-Hsiang Hsiao)

《物理治療》 44卷4期 (2019/12) Pp. 349-350

https://doi.org/10.6215/FJPT.201912.P77

摘要

Background and Purpose: Unintentional injury is one of the top 10 causes of death. In 2017, according to the Ministry of Health and Welfare, it was the 9th of the top causes of death in 75-84 years old people. The falls would cause a hip fracture in the elderly, and following reduced walking ability would affect the quality of life and increase fall risk. The purpose of this case report was to investigate the considerations of intervention in patient with femoral neck fracture participated in post-acute care. Methods: The case was a 77 year-old female with the right femoral neck fracture. She was independent in activities of daily living before this episode. The first time she came to the rehabilitation center of Lin-Shin Hospital, she could walk with a walker under supervision. She felt pain at operative area when the right hip joint was passively moved near the end range of extension and external rotation. The patient’s goal is to walk independently and to climb up and down the stairs by herself. The first step is to reduce the amount of support by assistive device. Following, the next step is to reduce the fall risk. Intervention began six days s/p right hemiarthroplasty. Regular intervention included two modality therapy and one movement therapy, and each item is 15 min. The motor function, Barthel Index and Harris Hip Score (HHS) were measured. Results: Two treatment sessions a day. Total 18 treatment sessions were completed. She walked first with a walker, then with a quadricane, and following without assistive devices. Initially, she climbed up and down the stairs with one hand on the handrail and the other hand supported by the therapist. After 5 days of training, she could climb up the stairs without support, but she went down the stairs still needed one hand on the handrail. Rocker Board training was used to enhance even weight-bearing of both legs and weight-transfer during steps after her motor function was achieved. Barthel Index was improved from 50 to 80. HHS was improved from 63 to 91. Conclusion: Post-acute care program can provide a chance for elderly patient with hip fracture to participate in an aggressive rehabilitation program, and the patient can improve motor functions through the program. Clinical Relevance: Elderly patients with hip fracture have more opportunity to return to one’s regular life through post-acute care program.